Type 2 Diabetes can lead to serious problems like heart attacks, strokes and kidney failure. But few people know about the condition - or that prevention is the best medicine.
The average German takes about 2,300 steps every day. That is the equivalent of about 1.7 kilometers. But Peter Schwarz walks much farther. The Dresden-based professor takes 10,000 steps a day - it is his rule of thumb for lowering the risk of developing Type 2 diabetes.
Schwarz is Europe's only Professor for the Prevention and Treatment of Diabetes.
The University Clinic of Dresden created his position in April 2009, with the aim of drawing public attention to the condition. Some research has suggested that people consider diabetes a minor problem. Schwarz wants to correct the misconception and improve prevention strategies.
Symptoms of diabetes
Worldwide, it is estimated that 366 million people live with diabetes. In Germany, there are about 4.7 million diabetics, and 90 percent suffer from diabetes mellitus type 2, or adult-onset diabetes.
Germans call it the sugar disease. But what is it exactly?
There are two main types of diabetes, but both mean that the body is not producing insulin in the way it should.
Insulin is needed to move sugar into cells, where it is stored until it's needed for energy. It is produced by special cells in the pancreas, called beta cells.
"It's the principle of the lock and key," says Stephan Schneider, chief physician at the Diabetology Clinic at Cologne's St. Vinzenz Hospital. "The insulin unlocks the cell and the glucose molecules enter the cell, where they are turned into energy."
However, when Type 1 Diabetes develops, those beta cells are destroyed and the body is unable to use the sugar - or glucose - for energy. This is known as an autoimmune disorder.
By contrast, Type 2 Diabetes is a metabolic disorder and is characterized by insulin resistance.
This means that insulin is produced but that the body fat, liver and muscles fail to respond to it. As a result, glucose remains in the blood, and that leads to high blood sugar levels, known as hyperglycemia.
In the case, blood sugar molecules can attach themselves to the cells' surface and slowly begin to destroy the membranes.
Diabetes Type 2 is treated by taking insulin to maintain normal blood sugar levels - either in the form of pills or by injection.
Diabetes can result in serious diseases
Diabetes can lead to high blood pressure, blindness, heart attacks and strokes. It can also affect the kidneys and damage nerves to the extent that patients lose feeling in their hands or feet.
Reiner Wolfrum knows these complications well - his biggest problem was the nerves in his feet.
"In Spring, my heel began to hurt," says Wolfrum. "It turned out the heel was completely contaminated with bacteria. Everything had to be removed to prevent the bacteria from spreading to the bone - or even having the foot amputated."
The wound refused to heal. But taking muscle tissue and skin from elsewhere on Wolfrum's body, the surgeons at St. Vinzenz Hospital were able to form a new heel for him. And they managed to save the foot.
Prevention is the best cure
Professor Schwarz says unhealthy diets and a lack of exercise are the main causes of diabetes.
"Over the past 20 years, people have been taking less and less exercise," says Schwarz, "they're burning an average of 500 to 700 calories less than they should."
People need less energy in their daily lives, but our diets mean we are eating more than before.
Even a little extra 'flab' can be damaging enough.
"A typical beer belly can consist of 10 to 15 kilos of fat," says Schwarz, "and that alone can raise the risks of diabetes by about 80 times."
But Schwarz says he has already made headway on the road to prevention.
The European Union is urging member states to take action.
"It's given member states four years to develop concrete programs to prevent diabetes - and start implementing them," says Schwarz.
But he concedes that such health programs often only constitute very small steps.